1) Know your procedures: Bariatric surgery has been around for many years. We are blessed medical research moves quickly. Weight loss surgery is no exception. The bad news is many procedures are still being performed unnecessarily and many countries and facilities are not offering the best procedures, they are the old standbys that create the bad rap and publicity that unfortunately haunts this life saving surgery.

2) Know your facilities: because weight loss surgery is up in the top 5 targeted procedures of medical tourism … Certain designs are awarded to facilities to insure patients of excellent care and standards. Please do not have surgery from a hospital that has not earned the International Center of Excellence (ICE) or more specifically the Bariatric Surgery Center of Excellence (BSCOE). The ASMBS (American Society for Metabolic and Bariatric Surgery) and SRC (Surgical Review Corporation) has 10 rigid criteria a hospital must meet to earn this design. Right here you can eliminate most facilities … this design is rarely awarded. Please do not make the assumption here these facilities are more expensive.

3) Know your surgeons: please note I say surgeons, plural. An October 2013 study published in the New England Journal of Medicine showed how bariatric surgeons were peer reviewed directly related to the surgeons success with patients … lowest complications greatest success of surgery. You can have the same procedure, but very different outcomes at the hands of different surgeons.

4) know the emergency capabilities of facility: This is yet another area where many facilities can be eliminated, truth is most do not have critical care diagnostics, equipment or a surgical Intensivist … a surgeon specialized in detecting potential emergency situations and there to take command if necessary.

5) If diabetic what are the chances it will put the diabetes into remission: no offense to aesthetics, these rules. Yes some procedures can put Type 2 diabetes into remission if there is significant, sustained weight loss. I implore you to choose a procedure that the procedure itself has a high potential to put diabetes into remission. This is true metabolic surgery that offers far greater health outlet in the present and future.

6) Fat loss vs weight loss: older procedures such as gastric bypass offered impressed sounding weight loss. However much of that weight is often muscle loss which predisposes patients to many other future illnesses and challenges. You want a procedure that ensures fat loss and cherishes your muscle mass.

7) Is the stomach left in tact? Again older procedures mangled the stomach. Over the last 15 years we have discovered many previously unknown magical mysteries of the stomach, which are obliterated in older unnecessary procedures such as gastric bypass. Beside horrid nutrient absorption, emotional mood disorders including alcoholism are associated with these procedures.

8) Are there any “foreign objects” left in the body? Your body is equipped with incredible sensors to detect and attack foreign objects such as gastric bands, staples … keep the stomach in tact and do not allow any clutter to be left in there !!!

9) What are the complication rates – not just of the procedure but of the particular surgeon, facility as well. Remember stats class? Numbers are fun, but can be dangerous. Marketing pros and PR folks can seriously fool you here. Get the straight answer on numbers of success and complications for surgeon, procedure performed at that facility, and other procedures performed there. Be real careful here.

10) Do they insist on a certain amount of weight loss before procedure? Yes you are there for weight loss surgery, however it is for your utmost protection that a certain amount of fat be lost before surgery for the liver. A good facility will guide you through this, and help you out if there is a problem

11) What pre operative and post operative support do they offer? It should not be take the money and run … this should be a relationship of trust that is built between you and the surgical staff. You are not on a factory conveyor belt. It is inexcusable a full pre and post nutritional, physical activity and lifestyle support program is not implemented with you.

12) What “promises” are they making you? Any great hospital will tell you weight loss surgery is NOT a get out of jail for free card. The realities of the procedure and future lifestyle should be deal with, openly and honestly. Weight loss surgery is a tool for success, not a magic lantern.

13) How accessible is the staff after the procedure? What systems do they have in place for you for questions, cheering you on? Do not settle for a FAQ sheet, you deserve human contact.

14) Quality of life post surgery. Again this is a point that truly saddens me. The older procedures put restrictions and encumbrances on the future joy of life that are just not necessary any more. Really really take a good look at this scientifically, life is to be enjoyed, and. Who are we kidding, we all have an inner foodie.

15) Are you willing to travel? The newest, safest most effective procedures are offered in a few places. The best surgeons … are you willing to travel … medical tourism is NOT popular just for cost savings – it is also the very best way to receive the state of the art care and facilities, cost effective and in a timely manner

Understand from all of these that it is inaccurate to judge a particular procedure when offered by different facilities – they will have different outcomes to many of these questions. It is very intimidating to make a decision on weight loss surgery, especially given all the “bad stories” that make it into the papers.The fact remains that weight loss surgery saves thousands of lives, and obesity is the # 1 killer – being responsible for so many of our chronic illnesses.